CHEST X-RAY COMPUTER-AIDED DETECTION TB, CAD4TB perp.license
Valid Article
OC subscriptions: included in supply or field order tools (e.g. UniField)
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SC subscriptions: included in supply or field tools
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OC validations: approved for procurement and use by an OC for international or local orders specifying context and activity in Medical Standard Lists (MSL)
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CHEST X-RAY COMPUTER-AIDED DETECTION TB
Definition
Computer-aided detection (CAD) software programs use artificial intelligence (AI) and deep learning techniques to analyse digital (not traditional film) chest X-ray images to detect and localize suspected radiographic abnormalities. These software programs are trained on large datasets (in some cases millions of Chest X-rays) and the quality and accuracy are constantly improving. CAD4TB is one of the CAD software programs used specifically to detect abnormalities associated with tuberculosis and has been shown to perform on par with experts (radiologists). CAD is has recently been endorsed by WHO for digital chest X-ray analysis for TB screening and triage in individuals aged 15 years and above.
Specifications
Automated X-ray reading for detecting tuberculosis
Components
CAD4TB AI solution for on-site processing, Perpetual license for 12 months, including:
- CAD4TBbox (nuc mini-computer for offline usage and image storage)
- CAD4TB software
- WIFI router for connection to the internet
- 10' tablet for viewing of images and results
- Installation and user manual
Technical specifications
- CAD4TB software
- version 4.10
- analyses the chest image on TB
- gives an abnormality score form 0 to 100
- result is instantly available (computation time of less than a minute)
Instructions for use
The CAD4TB offline box is connected to validated digital X-ray systems to receive Posterior – Anterior (PA) Chest X-ray images. The software installed on the box analyses the Chest X-ray in less than one minute. The output is a colour heat map showing suspected abnormalities related to TB, and a score between 0 – 100 representing the overall likelihood of TB. A threshold score is chosen to determine which patients should be referred for a follow-up test, such as GeneXpert, to confirm TB diagnosis. CAD4TB does not provide information about non-TB diagnoses, in many situations human readers are still required to review the Chest X-rays.
Use of digital chest X-ray with CAD requires integration into TB screening and triage protocols. A critical aspect of implementation is the initial choice and calibration of a ‘threshold' score. The performance of CAD4TB is highly dependent on the demographic characteristics of the population and thus the choice of threshold score must reflect the local context. (i.e. CAD4TB is not just ‘plug and play'). As there are other important details as well as known limitations with regards to this technology, please contact diagnostic-network@msf.org for more information.
MSF requirements
- CAD is not used for TB diagnosis
- CAD can help identify individuals who need to go for confirmatory testing (e.g. GeneXpert)
- Theshold score (e.g. 40) is selected, but needs to be calibrated according to the local conditions (population characteristics, CAD product and software version, X-ray equipment):
- CAD score > '40' => GeneXpert
- CAD score < '40' => No GeneXpert