Increasingly, computed tomography (CT) offers higher resolution and faster acquisition times. This has resulted in the opportunity to detect small lung nodules, which may represent lung cancers at earlier and potentially more curable stages. However, in the current clinical practice, hundreds of such thin-sectional CT images are generated for each patient and are evaluated by a radiologist in the traditional sense of looking at each image in the axial mode. This results in the potential to miss small nodules and thus potentially miss a cancer. In this paper, we present a computerized method for automated identification of small lung nodules on multislice CT (MSCT) images. The method consists of three steps: (i) separation of the lungs from the other anatomic structures, (ii) detection of nodule candidates in the extracted lungs, and (iii) reduction of false-positives among the detected nodule candidates. A three-dimensional lung mask can be extracted by analyzing density histogram of volumetric chest images followed by a morphological operation. Higher density structures including nodules scattered throughout the lungs can be identified by using a local density maximum algorithm. Information about nodules such as size and compact shape are then incorporated into the algorithm to reduce the detected nodule candidates which are not likely to be nodules. The method was applied to the detection of computer simulated small lung nodules (2 to 7 mm in diameter) and achieved a sensitivity of 84.2% with, on average, five false-positive results per scan. The preliminary results demonstrate the potential of this technique for assisting the detection of small nodules from chest MSCT images.
(c) 2003 American College of Medical Physics.