J Korean Soc Radiol.  2019 Sep;80(5):872-879. 10.3348/jksr.2019.80.5.872.

Application of Artificial Intelligence in Lung Cancer Screening

Affiliations
  • 1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 2Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea. cmpark.morphius@gmail.com

Abstract

Lung cancer is a leading cause of deaths due to cancer, worldwide. At present, low-dose computed tomography (CT) is the only established screening method for reducing lung cancer mortality. However, several challenges must be overcome, to ensure the implementation of lung cancer screening, which include a large number of expected low-dose CT examinations and relative shortage of experienced radiologists for interpreting them. The use of artificial intelligence has garnered attention in this regard. A deep learning technique, which is a subclass of machine learning methods, involving the learning of data representations in an end-to-end manner, has already demonstrated outstanding performance in medical image analysis. Several studies are exploring the possibility of deep learning-based applications in medical domains, including radiology. In lung cancer screening, computer-aided detection, report generation, prediction of malignancy in the detected nodules, and prognosis prediction can be considered for the application of artificial intelligence. This article will cover the current status of deep learning approaches, their limitations, and their potential in lung cancer screening programs.


MeSH Terms

Artificial Intelligence*
Cause of Death
Learning
Lung Neoplasms*
Lung*
Machine Learning
Mass Screening*
Methods
Mortality
Prognosis
Tomography, X-Ray Computed

Reference

References

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019.CA Cancer J Clin. 2019; 69:7–34.
2. National Lung Screening Trial Research Team. Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening.N Engl J Med. 2011; 365:395–409.
3. Nishi S, Zhou J, Kuo YF, Goodwin JS. Use of lung cancer screening with low-dose computed tomography in the medicare population.Mayo Clin Proc Innov Qual Outcomes. 2019; 3:70–77.
4. Lee JG, Jun S, Cho YW, Lee H, Kim GB, Seo JB, et al. Deep learning in medical imaging: general overview. Korean J Radiol. 2017; 18:570–584.
Article
5. National Lung Screening Trial Research Team. Church TR, Black WC, Aberle DR, Berg CD, Clingan KL, et al. Results of initial low-dose computed tomographic screening for lung cancer.N Engl J Med. 2013; 368:1980–1991.
6. Liang M, Tang W, Xu DM, Jirapatnakul AC, Reeves AP, Henschke CI, et al. Low-dose CT screening for lung cancer: computer-aided detection of missed lung cancers.Radiology. 2016; 281:279–288.
7. Zhao Y, De Bock GH, Vliegenthart R, Van Klaveren RJ, Wang Y, Bogoni L, et al. Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume. Eur Radiol. 2012; 22:2076–2084.
Article
8. Henschke CI, Yip R, Yankelevitz DF, Smith JP; International Early Lung Cancer Action Program Investigators. Definition of a positive test result in computed tomography screening for lung cancer: a cohort study.Ann Intern Med. 2013; 158:246–252.
9. Lo SB, Freedman MT, Gillis LB, White CS, Mun SK. Journal club: computer-aided detection of lung nodules on CT with a computerized pulmonary vessel suppressed function. AJR Am J Roentgenol. 2018; 210:480–488.
10. Armato SG 3rd, McLennan G, Bidaut L, McNitt-Gray MF, Meyer CR, Reeves AP, et al. The Lung Image Database Consortium (LIDC) and Image Database Resource Initiative (IDRI): a completed reference database of lung nodules on CT scans.Med Phys. 2011; 38:915–931.
11. Hua KL, Hsu CH, Hidayati SC, Cheng WH, Chen YJ. Computer-aided classification of lung nodules on computed tomography images via deep learning technique. Onco Targets Ther. 2015; 8:2015–2022.
12. Setio AA, Ciompi F, Litjens G, Gerke P, Jacobs C, Van Riel SJ, et al. Pulmonary nodule detection in CT images: false positive reduction using multi-view convolutional networks.IEEE Trans Med Imag/iing. 2016; 35:1160–1169.
13. Jacobs C, Van Rikxoort EM, Murphy K, Prokop M, Schaefer-Prokop CM, Van Ginneken B. Computer-aided detection of pulmonary nodules: a comparative study using the public LIDC/IDRI database.Eur Radiol. 2016; 26:2139–2147.
14. Henschke CI, Yankelevitz DF, Mirtcheva R, McGuinness G, McCauley D, Miettinen OS, et al. CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules.AJR Am J Roentgenol. 2002; 178:1053–1057.
15. Li F, Sone S, Abe H, Macmahon H, Doi K. Malignant versus benign nodules at CT screening for lung cancer: comparison of thin-section CT findings. Rad/iiology. 2004; 233:793–798.
Article
16. Nakata M, Saeki H, Takata I, Segawa Y, Mogami H, Mandai K, et al. Focal groundglass opacity detected by low-dose helical CT.Chest. 2002; 121:1464–1467.
17. Benzakoun J, Bommart S, Coste J, Chassagnon G, Lederlin M, Boussouar S, et al. Computer-aided diagnosis.
18. Silva M, Schaefer-Prokop CM, Jacobs C, Capretti G, Ciompi F, Van Ginneken B, et al. Detection of subsolid nodules in lung cancer screening: complementary sensitivity of visual reading and computer-aided diagnosis. Invest Radiol. 2018; 53:441–449.
19. Li L, Liu Z, Huang H, Lin M, Luo D. Evaluating the performance of a deep learning-based computer-aided diagnosis (DL-CAD) system for detecting and characterizing lung nodules: comparison with the performance.
20. Al Mohammad B, Brennan PC, Mello-Thoms C. A review of lung cancer screening and the role of computer-aided detection. Clin Radiol. 2017; 72:433–442.
Article
21. Van Riel SJ, Sánchez CI, Bankier AA, Naidich DP, Verschakelen J, Scholten ET, et al. Observer variability for classification of pulmonary nodules on low-dose CT images and its effect on nodule management.Radiology. 2015; 277:863–871.
22. Ciompi F, Chung K, Van Riel SJ, Setio AAA, Gerke PK, Jacobs C, et al. Towards automatic pulmonary nodule management in lung cancer screening with deep learning.Sci Rep. 2017; 7:46479.
23. Brown M, Browning P, Wahi-Anwar MW, Murphy M, Delgado J, Greenspan H, et al. Integration of chest CT CAD into the clinical workflow and impact on radiologist efficiency.Acad Radiol. 2019; 26:626–631.
24. Ronneberger O, Fischer P, Brox T.U-Net: convolutional networks for biomedical image segmentation. In Navab N, Hornegger J, Wells W, Frangi A, eds.Medical Image Computing and Computer-Assisted Intervention–MICCAI 2015. MICCAI 2015. Lecture Notes in Computer Science, vol 9351. Cham:. Springer;2006. p. 234–241.
25. Huang P, Park S, Yan R, Lee J, Chu LC, Lin CT, et al. Added value of computer-aided CT image features for early lung cancer diagnosis with small pulmonary nodules: a matched case-control study.Radiology. 2018; 286:286–295.
26. Ardila D, Kiraly AP, Bharadwaj S, Choi B, Reicher JJ, Peng L, et al. End-to-end lung cancer screening with three-dimensional deep learning on low-dose chest computed tomography. Nat Med. 2019; 25:954–961.
Article
27. McWilliams A, Tammemagi MC, Mayo JR, Roberts H, Liu G, Soghrati K, et al. Probability of cancer in pulmonary nodules detected on first screening CT.N Engl J Med. 2013; 369:910–919.
28. White CS, Dharaiya E, Dalal S, Chen R, Haramati LB. Vancouver risk calculator compared with ACR lung-RADS in predicting malignancy: analysis of the national lung screening trial.Radiology. 2019; 291:205–211.
29. Maldonado F, Duan F, Raghunath SM, Rajagopalan S, Karwoski RA, Garg K, et al. Noninvasive computed tomography-based risk stratification of lung adenocarcinomas in the national lung screening trial.Am J Respir Crit Care Med. 2015; 192:737–744.
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