ArticleRadiology2018
Added Value of Computer-aided CT Image Features for Early Lung Cancer Diagnosis with Small Pulmonary Nodules: A Matched Case-Control Study.
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Article in Radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers.
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71citing papers in PubMed
14.9field-weighted citation impact, top 1% of its field
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71 citing papers in PubMed, 178 citations in OpenAlex.
- Diagnostic performance of commercial AI systems versus participating radiologists for pulmonary nodule detection in routine clinical practice.Japanese journal of radiology · 2026Article
- Innovative approaches for lung cancer screening and interception.Nature reviews. Clinical oncology · 2026Review
- MedScanGAN: Synthetic PET & CT Scan Generation Using Conditional Generative Adversarial Networks for Medical AI Data Augmentation.Bioengineering (Basel, Switzerland) · 2026Article
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- China Protocol for early screening, precise diagnosis, and individualized treatment of lung cancer.Signal transduction and targeted therapy · 2025Review
- Analysis of Research Hotspots and Development Trends in the Diagnosis of Lung Diseases Using Low-Dose CT Based on BibliometricsCurrent medical imaging · 2025Review
- Differentiation of early-stage tumors from benign lesions manifesting as pure ground-glass nodule: a clinical prediction study based on AI-derived quantitative parameters.Frontiers in oncology · 2025Article
- An Efficient Dual-Sampling Approach for Chest CT Diagnosis.Journal of multidisciplinary healthcare · 2025Article
- Radiomics and artificial intelligence for risk stratification of pulmonary nodules: Ready for primetime?Cancer biomarkers : section A of Disease markers · 2025Review
- Lung cancer screening in India: Preparing for the future using smart tools & biomarkers to identify highest risk individuals.The Indian journal of medical research · 2024Review
- Growth dynamics of lung nodules: implications for classification in lung cancer screening.Cancer imaging : the official publication of the International Cancer Imaging Society · 2024Article
- Current Evidence for a Lung Cancer Screening Program.Portuguese journal of public health · 2024Review
- Mesoporous silica nanoparticles: a versatile carrier platform in lung cancer management.Nanomedicine (London, England) · 2024Review
- Accuracy of solid portion size measured on multiplanar volume rendering images for assessing invasiveness in lung adenocarcinoma manifesting as subsolid nodules.Quantitative imaging in medicine and surgery · 2024Article
- Emerging Strategies in Lung Cancer Screening: Blood and Beyond.Clinical chemistry · 2024Review
- The effectiveness of deep learning model in differentiating benign and malignant pulmonary nodules on spiral CT.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024Article
- Article
- Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed.Diagnostics (Basel, Switzerland) · 2023Review
- Radiomics-Guided Global-Local Transformer for Weakly Supervised Pathology Localization in Chest X-Rays.IEEE transactions on medical imaging · 2023Article
- Application of radiomics in diagnosis and treatment of lung cancer.Frontiers in pharmacology · 2023Review
11 more citing papers are in PubMed but not listed here.
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Authors and funding
17 authors at 6 institutions in 3 countries.
Peng HuangFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Seyoun ParkFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Rongkai YanFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Junghoon LeeFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Linda C ChuFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Cheng T LinFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Amira HussienFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Joshua RathmellFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Brett ThomasFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Chen ChenFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Russell HalesFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
David S EttingerFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Malcolm BrockFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Ping HuFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Elliot K FishmanFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Edward GabrielsonFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Stephen LamFrom the Departments of Oncology (P. Huang, D.S.E.), Radiology (E.K.F., L.C.C., C.T.L., A.H.), Radiation Oncology and Molecular Radiation Sciences (S.P., J.L., R.H.), Surgery (M.B.), Pathology (E.G.), and Biostatistics (J.S.), Johns Hopkins University School of Medicine, 550 N Broadway, Suite 1103, Baltimore, MD 21205; Department of Medicine, the University of British Columbia, Vancouver, BC, Canada (S.L.); Information Management Services, Rockville, Md (J.R., B.T.); Biometry Research Group, National Cancer Institute, Bethesda, Md (P. Hu); Department of Radiology, Nongken General Hospital of Hainan Medical University, Haikou, Hainan, China (R.Y.); and Department of Thoracic Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China (C.C.).
Johns Hopkins University · USJohns Hopkins Medicine · USInformation Management Services · USCentral South University · CNHainan Medical University · CNUniversity of British Columbia · CA
Funding
Translational Research Central ServicesP30CA006973 · NCI · JOHNS HOPKINS UNIVERSITY · PI Rosalie Wollett · 1985 to 2026
$208.6MNCI NIH HHS P30 CA006973
Abstract
Purpose To test whether computer-aided diagnosis (CAD) approaches can increase the positive predictive value (PPV) and reduce the false-positive rate in lung cancer screening for small nodules compared with human reading by thoracic radiologists. Materials and Methods A matched case-control sample of low-dose computed tomography (CT) studies in 186 participants with 4-20-mm noncalcified lung nodules who underwent biopsy in the National Lung Screening Trial (NLST) was selected. Variables used for matching were age, sex, smoking status, chronic obstructive pulmonary disease status, body mass index, study year of the positive screening test, and screening results. Studies before lung biopsy were randomly split into a training set (70 cancers plus 70 benign controls) and a validation set (20 cancers plus 26 benign controls). Image features from within and outside dominant nodules were extracted. A CAD algorithm developed from the training set and a random forest classifier were applied to the validation set to predict biopsy outcomes. Receiver operating characteristic analysis was used to compare the prediction accuracy of CAD with the NLST investigator's diagnosis and readings from three experienced and board-certified thoracic radiologists who used contemporary clinical practice guidelines. Results In the validation cohort, the area under the receiver operating characteristic curve for CAD was 0.9154. By default, the sensitivity, specificity, and PPV of the NLST investigators were 1.00, 0.00, and 0.43, respectively. The sensitivity, specificity, PPV, and negative predictive value of CAD and the three radiologists' combined reading were 0.95, 0.88, 0.86, and 0.96 and 0.70, 0.69, 0.64, and 0.75, respectively. Conclusion CAD could increase PPV and reduce the false-positive rate in the early diagnosis of lung cancer.
Indexed as
AgedAlgorithmsCase-Control StudiesEarly Detection of CancerFemaleHumansImage Interpretation, Computer-AssistedLung NeoplasmsMaleMiddle AgedMultiple Pulmonary NodulesReproducibility of ResultsTomography, X-Ray Computed
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