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AI Tool Predicts Cancer Risk in Lung Nodules Seen on CT Scans

By MedImaging International staff writers
Posted on 25 May 2022

Image: Researchers used AI to predict cancer risk of lung nodules (Photo courtesy of Pexels)

Pulmonary nodules appear as small spots on the lungs on chest imaging. They have become a much more common finding as CT has gained favor over X-rays for chest imaging. Now, a new study has found that an artificial intelligence (AI) tool can help doctors predict the cancer risk in lung nodules seen on CT.

Researchers at the University of Pennsylvania (Pennsylvania, PA, USA) evaluated an AI-based computer-aided diagnosis tool developed by Optellum Ltd. (Oxford, UK) to assist clinicians in assessing pulmonary nodules on chest CT. While CT scans show many aspects of the nodule, such as size and border characteristics, AI can delve even deeper.

In the study, six radiologists and six pulmonologists made estimates of malignancy risk for nodules using CT imaging data alone. They also made management recommendations such as CT surveillance or a diagnostic procedure for each case without and with the AI tool. A total of 300 chest CTs of indeterminant pulmonary nodules were used in the study. The researchers defined indeterminant nodules as those between 5 and 30 millimeters in diameter. Their analysis showed that use of the AI tool improved estimation of nodule malignancy risk on chest CT. It also improved agreement among the different readers for both risk stratification and management recommendations. The model appears to work equally well on diagnostic CT and low-dose screening CT, although more study is needed before the AI tool can be used in the clinic.

“A nodule would appear on somewhere between 5% to 8% of chest X-rays,” said study senior author Anil Vachani, M.D., director of clinical research in the section of Interventional Pulmonology and Thoracic Oncology at the Perelman School of Medicine, University of Pennsylvania in Philadelphia. “Chest CT is such a sensitive test, you’ll see a small nodule in upwards of a third to a half of cases. AI can go through very large datasets to come up with unique patterns that can’t be seen through the naked eye and end up being predictive of malignancy.”

“The readers judge malignant or benign with a reasonable level of accuracy based on imaging itself, but when you combine their clinical interpretation with the AI algorithm, the accuracy level improves significantly,” added Dr. Vachani. “The level of improvement suggests that this tool has the potential to change how we judge cancer versus benign and hopefully improve how we manage patients. We’ve taken the first step here and shown that decision making is better if the AI tool is incorporated into radiology or pulmonology practice. The next step is to take the tool and do some prospective trials where physicians use the AI tool in a real-world setting. We are in the process of designing those trials.”

Related Links:
University of Pennsylvania
Optellum Ltd.

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68 (187.87384033203): SELECT fid FROM jos_deeppockets WHERE id=294793081 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294793081 AND published='1' LIMIT 1

69 (36.954879760742): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (335.9317779541): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793081 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 5023.9562988281): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793081 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 3157.8540802002): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (607.01370239258): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (!!!!! 1860.1417541504): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (24.080276489258): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (24.080276489258): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (167.8466796875): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (127.07710266113): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (148.05793762207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (41.961669921875): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793081 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (232.93495178223): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793081 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (351.90582275391): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (967.02575683594): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (!!!!! 2871.036529541): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (358.10470581055): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (126.12342834473): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (95.129013061523): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (626.0871887207): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (430.10711669922): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (576.01928710938): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (329.01763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (546.93222045898): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (654.93583679199): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (406.98051452637): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (864.02893066406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

105 (925.06408691406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

106 (750.06484985352): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793081 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (993.96705627441): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793081 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 2872.9438781738): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

109 (424.86190795898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

110 (618.93463134766): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294793081 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (865.93627929688): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294793081 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (543.83277893066): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (340.93856811523): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

115 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

116 (112.05673217773): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

117 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

118 (115.87142944336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

119 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

120 (277.99606323242): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 74953.079223633): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (!!!!! 3925.085067749): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

123 (608.92105102539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

124 (964.87998962402): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793081 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793081 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1926331.0432434): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 1276020.0500488): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (689.98336791992): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (562.90626525879): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (854.9690246582): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (542.87910461426): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (771.99935913086): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (880.00297546387): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (344.99168395996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (446.08116149902): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (61.988830566406): SELECT name FROM jos_deeppockets WHERE id=215

136 (39.100646972656): SELECT name FROM jos_deeppockets WHERE id=215

137 (571.96617126465): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (!!!!! 5913.9728546143): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 1137.9718780518): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

140 (!!!!! 12491.941452026): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

141 (!!!!! 30296.087265015): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 2894.8783874512): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793081 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (!!!!! 1208.0669403076): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793081 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (637.05444335938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (259.8762512207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (484.94338989258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

147 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

148 (!!!!! 2214.9085998535): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (163.07830810547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

150 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

151 (536.91864013672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793081 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793081 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (42.915344238281): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (31.948089599609): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (31.948089599609): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

156 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793081 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793081 AND published='1' LIMIT 1

157 (37.193298339844): select jos_twitters.link from jos_twitters where cat=10

158 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

159 (29.087066650391): select jos_google_plus.link from jos_google_plus where cat=10

160 (73.909759521484): select jos_linkedin.link from jos_linkedin where cat=10

161 (458.95576477051): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1652.0023345947): insert into jos_banners_delta values (14615,'2025-05-01 18:07:03','3.137.203.53','view'),(14202,'2025-05-01 18:07:03','3.137.203.53','view'),(14203,'2025-05-01 18:07:03','3.137.203.53','view')

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