A Web- and Cloud- based Service for the Clinical Use of a CAD (Computer Aided Detection) System - Automated Detection of Lung Nodules in Thoracic CTs (Computed Tomographies)

M5L, a Web-based Computer-Aided Detection (CAD) system to automatically detect lung nodules in thoracic Computed Tomographies, is based on a multi-thread analysis by independent subsystems and the combination of their results. The validation on 1043 scans of 3 independent data-sets showed consistency across data-sets, with a sensitivity of about 80% in the 4-8 range of False Positives per scan, despite varying acquisition and reconstruction parameters and annotation criteria. To make M5L CAD available to users without hardware or software new installations and configuration, a Software as a Service (SaaS) approach was adopted. A web front-end handles the work (image upload, results notification and direct on-line annotation by radiologists) and the communication with the OpenNebula-based cloud infrastructure, that allocates virtual computing and storage resources. The exams uploaded through the web interface are anonymised and analysis is performed in an isolated and independent cloud environment. The average processing time for case is about 20 minutes and up to 14 cases can be processed in parallel. Preliminary results on the on-going clinical validation shows that the M5L CAD adds 20% more nodules originally overlooked by radiologists, allowing a remarkable increase of the overall detection sensitivity.