Hybrid method for the detection of pulmonary nodules using positron emission tomography/computed tomography: A preliminary study

Purpose: In this study, an automated scheme for detecting pulmonary nodules using a novel hybrid PET/CT approach is proposed, which is designed to detect pulmonary nodules by combining data from both sets of images. Methods: Solitary nodules were detected on CT by a cylindrical filter that we developed previously, and in the PET imaging, high-uptake regions were detected automatically using thresholding based on standardized uptake values along with false-positive reduction by means of the anatomical information obtained from the CT images. Initial candidate nodules were identified by combining the results. False positives among the initial candidates were eliminated by a rule-based classifier and three support vector machines on the basis of the characteristic features obtained from CT and PET images. Results: We validated the proposed method using 100 cases of PET/CT images that were obtained during a cancer-screening program. The detection performance was assessed by free-response receiver operating characteristic (FROC) analysis. The sensitivity was 83.0 % with the number of false positives/case at 5.0, and it was 8 % higher than the sensitivity of independent detection systems using CT or PET images alone. Conclusion: Detection performance indicates that our method may be of practical use for the identification of pulmonary nodules in PET/CT images.