Deep convolutional neural networks for multi-planar lung nodule detection: improvement in small nodule identification

Objective: In clinical practice, small lung nodules can be easily overlooked by radiologists. The paper aims to provide an efficient and accurate detection system for small lung nodules while keeping good performance for large nodules. Methods: We propose a multi-planar detection system using convolutional neural networks. The 2-D convolutional neural network model, U-net++, was trained by axial, coronal, and sagittal slices for the candidate detection task. All possible nodule candidates from the three different planes are combined. For false positive reduction, we apply 3-D multi-scale dense convolutional neural networks to efficiently remove false positive candidates. We use the public LIDC-IDRI dataset which includes 888 CT scans with 1186 nodules annotated by four radiologists. Results: After ten-fold cross-validation, our proposed system achieves a sensitivity of 94.2% with 1.0 false positive/scan and a sensitivity of 96.0% with 2.0 false positives/scan. Although it is difficult to detect small nodules (i.e. < 6 mm), our designed CAD system reaches a sensitivity of 93.4% (95.0%) of these small nodules at an overall false positive rate of 1.0 (2.0) false positives/scan. At the nodule candidate detection stage, results show that a multi-planar method is capable to detect more nodules compared to using a single plane. Conclusion: Our approach achieves good performance not only for small nodules, but also for large lesions on this dataset. This demonstrates the effectiveness and efficiency of our developed CAD system for lung nodule detection. Significance: The proposed system could provide support for radiologists on early detection of lung cancer.