Deep Convolutional Neural Network–based Software Improves Radiologist Detection of Malignant Lung Nodules on Chest Radiographs

Multicenter studies are required to validate the added benefit of using deep convolutional neural network (DCNN) software for detecting malignant pulmonary nodules on chest radiographs. To compare the performance of radiologists in detecting malignant pulmonary nodules on chest radiographs when assisted by deep learning–based DCNN software with that of radiologists or DCNN software alone in a multicenter setting. Investigators at four medical centers retrospectively identified 600 lung cancer–containing chest radiographs and 200 normal chest radiographs. Each radiograph with a lung cancer had at least one malignant nodule confirmed by CT and pathologic examination. Twelve radiologists from the four centers independently analyzed the chest radiographs and marked regions of interest. Commercially available deep learning–based computer-aided detection software separately trained, tested, and validated with 19 330 radiographs was used to find suspicious nodules. The radiologists then reviewed the images with the assistance of DCNN software.