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Open Access Accuracy of an automated system for tuberculosis detection on chest radiographs in high-risk screening

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SETTING: Tuberculosis (TB) screening programmes can be optimised by reducing the number of chest radiographs (CXRs) requiring interpretation by human experts.

OBJECTIVE: To evaluate the performance of computerised detection software in triaging CXRs in a high-throughput digital mobile TB screening programme.

DESIGN: A retrospective evaluation of the software was performed on a database of 38 961 postero-anterior CXRs from unique individuals seen between 2005 and 2010, 87 of whom were diagnosed with TB. The software generated a TB likelihood score for each CXR. This score was compared with a reference standard for notified active pulmonary TB using receiver operating characteristic (ROC) curve and localisation ROC (LROC) curve analyses.

RESULTS: On ROC curve analysis, software specificity was 55.71% (95%CI 55.21–56.20) and negative predictive value was 99.98% (95%CI 99.95–99.99), at a sensitivity of 95%. The area under the ROC curve was 0.90 (95%CI 0.86–0.93). Results of the LROC curve analysis were similar.

CONCLUSION: The software could identify more than half of the normal images in a TB screening setting while maintaining high sensitivity, and may therefore be used for triage.
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Keywords: TB; chest radiography; computer-aided detection; computerised image analysis

Document Type: Research Article

Affiliations: 1: Diagnostic Image Analysis Group, Radboud University Medical Center, Nijmegen, Thirona, Nijmegen, The Netherlands 2: Diagnostic Image Analysis Group, Radboud University Medical Center, Nijmegen 3: Department of Infectious Disease Informatics, Institute of Health Informatics, University College London, London 4: Department of Infectious Disease Informatics, Institute of Health Informatics, University College London, London, Institute of Epidemiology and Health Care, University College London 5: Institute for Global Health, University College London, UK

Publication date: 01 May 2018

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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