Deep Learning-Based Artificial Intelligence for

Multiple Pulmonary Nodules Identification: A Systematic Review

Felicia Sidharta¹, William Atmadji¹, Cecilia Arivia¹, Giuseppe Lintang Triaswhoro¹, William Winston Sito¹, Chelsie Angelius¹,
Andree Kurniawan², Ian Huang²
¹Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
²Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten Indonesia

BACKGROUND RESULT Risk of Bias Assessment

Lung cancer, a highly perilous disease, demands We included 4 retrospective observational
Table of Outcome
early diagnosis and detection to enhance survival studies and 1 clinical trial with a total of 6.191
rate. Recently, Artificial Intelligence (AI) has cases in this review.
revolutionized medical imaging diagnostics and has Our study shows that deep learning-based AI Mean Study Outcome
No. Authors Study Design Intervention Conclusion
become one of the most active research directions in enhances clinical decision-making for Age Population Measured

The machine learning

this field. This review aims to assess the performance pulmonary nodule management and Machine learning
Predicting the
malignancy based PKU-ML AI model
Xinling Li, based PKU-ML AI of single solid can better predict the
1 Clinical Trial 61.4 287
of a deep learning–based nodule detection improved lung cancer detection. et al model pulmonary
nodules.
malignancy of solid
nodules in multiple
pulmonary nodules.
algorithm for the early detection of lung cancer on All 5 studies support that AI has been shown to
chest images. increase the accuracy of early lung cancer Identification of Studies AI algorithm was applied,
the sensitivity was 94%,
To know the
diagnosis, reduce detection time, and provide Via Databases
2
Hyunsuk Retrospective
64.5 577
Deep
sensitivity and
specificitty of AI
specificity 83%, positive
predictive value 3%, and
Yoo, et al Observational learning- predicting negative predictive value

Identification
noninvasive approaches for evaluating based AI malignancy. was 100% for the
detection of malignant
Studies identified
METHODS pulmonary nodules on chest images.
in the databases LÒ
pulmonary nodules.

The cancer detection

(n = 4.026) rates of AI and radiologists
Evaluate the are 100%. The sensitivity of
We conducted a thorough literature search, utilizing 3
K Zhang, Retrospective
59 158
Deep-
learning-
performance of AI AI on nodule detection
Irrelevancies et al Observational in the detection of was significantly higher
based Artificial
relevant MeSH terms within PubMed, Google Scholar, Incomplete articles malignant than that of radiologists

CONCLUSION
Intelligence
(n = 3.788) nodules. (99.1% vs 43%, P<0.001)

and Cochrane Library databases for studies

Screening
published after 2019. Pre-selected studies This AI-assisted program
In conclusion, deep learning-based AI has (n = 238) Chou-Chin Retrospective
Deep To prove the significantly reduced FP.

Our focus was on assessing AI algorithms trained for 4

Lan, et al Observational
61 60 Learning-
based Artificial
effectiveness in
clinical
The AI-assisted program
improved the detection
demonstrated its capacity to enhance the LÒ Intelligence practice. of error-prone nodules.
radiographic interpretation to detect malignancy in Did not fit with

predictive accuracy of malignancy in multiple inclusion criteria

pulmonary nodules compared to radiologists and (n = 216)
To compare the
It improves detection

pulmonary nodules, while also achieving good

performance for all
performance
other machines. Artificial readers in both screening

Eligibility
and reading time
Studies potentially eligible intelligence- of different
and clinical routine

We excluded studies with low-quality or incomplete performance in reducing human errors during for inclusion
5
H-H. Hsu,
et al
Retrospective
Observational
62.5 340 powered
computer-
readers using
practice. Concurrent use
of Computer Aided
automatic AI-
aided detection System is more efficient
CT scan images and patients diagnosed with the identification of chest imaging. (n = 22) system
powered
computer-aided
for both junior and senior
readers.
detection.
neoplasm diseases other than malignancy. Poor research quality
by NOS and JADAD
We included studies involving adult patients (age ≥ (n=17)

18 years) with confirmed diagnosis of pulmonary Studies included

Included
Keywords: in the review
nodules. To assess study quality, we used the NOS
Multiple Pulmonary Nodule, Deep Learning, (n = 5) CONTACT felicia.sidharta@icloud.com
and JADAD Score.
Artificial Intelligence, Lung Cancer