Study finds reduced sensitivity in low-dose CT scans for pediatric lung nodules

Two lung-nodule computer-aided detection (CAD) systems have demonstrated reduced sensitivity on low- versus standard-dose computed tomography (CT) scans for small nodules in pediatric patients, according to a study published online Oct. 9 in the American Journal of Roentgenology.

Russell C. Hardie, Ph.D., from the University of Dayton in Ohio, and colleagues conducted a retrospective study of 73 patients (mean age, 14.7 years) who underwent clinical standard-dose and investigational low-dose chest CT examinations within the same encounter.

Two publicly available lung-nodule CAD systems that had been trained using adult data—FlyerScan and Medical Open Network for Artificial Intelligence (MONAI)—were used to process both CT scans. The sensitivities for 247 nodules measuring 3 to 30 mm were calculated when operating at a fixed frequency of two false-positives per scan.

The researchers found that the detection sensitivities were 76.9 and 66.8% on standard-dose and low-dose scans for FlyerScan, respectively, and 67.6 and 62.3%, respectively, for MONAI. For standard- versus low-dose scans, the number of detected nodules was 33 versus 24 (FlyerScan) and 16 versus 13 (MONAI) for 3-mm nodules; 46 versus 42 (FlyerScan) and 39 versus 30 (MONAI) for 4-mm nodules; 38 versus 33 (FlyerScan) and 32 versus 31 (MONAI) for 5-mm nodules; and 27 versus 20 (FlyerScan) and 24 versus 24 (MONAI) for 6-mm nodules. Detection did not show a consistent pattern between standard- and low-dose scans for either system for nodules measuring ≥7 mm.

“The findings indicate the need for caution when using low-dose protocols in combination with CAD systems to help detect small lung nodules in pediatric patients,” the authors write.

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