Computer-Aided Detection of Pulmonary Nodules in Computed Tomography Using ClearReadCT

  • Anne-Kathrin Wagner
  • Arno Hapich
  • Marios Nikos Psychogios
  • Ulf Teichgräber
  • Ansgar Malich
  • Ismini PapageorgiouEmail author
Image & Signal Processing
Part of the following topical collections:
  1. Image & Signal Processing


This study evaluates the accuracy of a computer-aided detection (CAD) application for pulmonary nodular lesions (PNL) in computed tomography (CT) scans, the ClearReadCT (Riverain Technologies). The study was retrospective for 106 biopsied PNLs from 100 patients. Seventy-five scans were Contrast-Enhanced (CECT) and 25 received no enhancer (NECT). Axial reconstructions in soft-tissue and lung kernel were applied at three different slice thicknesses, 0.75 mm (CECT/NECT n = 25/6), 1.5 mm (n = 18/9) and 3.0 mm (n = 43/18). We questioned the effect of (1) enhancer, (2) kernel and (3) slice thickness on the CAD performance. Our main findings are: (1) Vessel suppression is effective and specific in both NECT and CECT. (2) Contrast enhancement significantly increased the CAD sensitivity from 60% in NECT to 80% in CECT, P = 0.025 Fischer’s exact test. (3) The CAD sensitivity was 84% in 3 mm slices compared to 68% in 0.75 mm slices, P > 0.2 Fischer’s exact test. (4) Small lesions of low attenuation were detected with higher sensitivity. (5) Lung kernel reconstructions increased the false positive rate without affecting the sensitivity (P > 0.05 McNemar’s test). In conclusion, ClearReadCT showed an optimized sensitivity of 84% and a positive predictive value of 67% in enhanced lung scans with thick, soft kernel reconstructions. NECT, thin slices and lung kernel reconstruction were associated with inferior performance.


nodule classification segmentation vessel suppression background elimination lung cancer 



Somatom definition AS 16-row CT scanner


Somatom emotion 16-row CT scanner


Somatom definition AS 64-row CT scanner


Computer-aided detection


Contrast-enhanced computed tomography


Computed tomography


False negative


False positive


Hounsfield Units


Non-enhanced computed tomography


Picture archiving and communication system


Pulmonary nodular lesions


Positive predictive value


True negative


True positive


True positive rate (sensitivity)


CAD version 1


CAD version 2


Compliance with the ethical standards

The study was approved by the Ethics Committee of the University Hospital of Jena and was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its amendments, the European Regulation 536/2014 as well as with the good clinical and scientific practice protocols of the University of Jena. For this type of study a formal consent was not required.

Supplementary material

10916_2019_1180_MOESM1_ESM.pdf (58 kb)
ESM 1 (PDF 57 kb)
10916_2019_1180_MOESM2_ESM.pdf (51 kb)
ESM 2 (PDF 51 kb)
10916_2019_1180_MOESM3_ESM.pdf (109 kb)
ESM 3 (PDF 109 kb)
10916_2019_1180_MOESM4_ESM.xlsx (70 kb)
ESM 4 (XLSX 70 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of Diagnostic and Interventional RadiologyUniversity Hospital JenaJenaGermany
  2. 2.Institute of RadiologySüdharz Hospital NordhausenNordhausenGermany
  3. 3.Department of Thoracic SurgerySüdharz Hospital NordhausenNordhausenGermany
  4. 4.Institute of Diagnostic and Interventional NeuroradiologyUniversity Medicine GöttingenGöttingenGermany

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