• Yu Wang, Bo Wu, Nan Zhang, Jiabao Liu, Fei Ren, and Liqin Zhao.
• School of Biomedical Engineering, Capital Medical University, Beijing, China.
• J Xray Sci Technol. 2020 Jan 1; 28 (1): 1-16.

Background And ObjectiveSince CAD (Computer Aided Diagnosis) system can make it easier and more efficient to interpret CT (Computer Tomography) images, it has gained much attention and developed rapidly in recent years. This article reviews recent CAD techniques for pulmonary nodule detection and diagnosis in CT Images.MethodsCAD systems can be classified into computer-aided detection (CADe) and computer-aided diagnosis (CADx) systems. This review reports recent researches of both systems, including the database, technique, innovation and experimental results of each work. Multi-task CAD systems, which can handle segmentation, false positive reduction, malignancy prediction and other tasks at the same time. The commercial CAD systems are also briefly introduced.ResultsWe have found that deep learning based CAD is the mainstream of current research. The reported sensitivity of deep learning based CADe systems ranged between 80.06% and 94.1% with an average 4.3 false-positive (FP) per scan when using LIDC-IDRI dataset, and between 94.4% and 97.9% with an average 4 FP/scan when using LUNA16 dataset, respectively. The overall accuracy of deep learning based CADx systems ranged between 86.84% and 92.3% with an average AUC of 0.956 reported when using LIDC-IDRI dataset.ConclusionsWe summarized the current tendency and limitations as well as future challenges in this field. The development of CAD needs to meet the rigid clinical requirements, such as high accuracy, strong robustness, high efficiency, fine-grained analysis and classification, and to provide practical clinical functions. This review provides helpful information for both engineering researchers and radiologists to learn the latest development of CAD systems.

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