AI-derived computer-aided detection (CAD) software for detecting and measuring lung nodules in CT scan images
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1 Recommendations
NICE is aware that companies are reviewing their CE marking in response to changes and advances in regulations for digital health technologies.
1.1 There is not enough evidence to recommend AI‑derived computer-aided detection (CAD) software alongside clinician review of CT scan images to detect and measure lung nodules in, or outside of, targeted lung cancer screening.
1.2 Centres already using AI‑derived CAD software alongside clinician review as part of targeted lung cancer screening may continue to do so, but only if further data is collected to make sure the benefits for people attending screening and clinicians using the software are realised in practice (see section 1.3).
1.3 Further data collection and research is recommended (see the section on further research) to assess:
how using CAD software alongside clinician review of CT scan images affects the accuracy of detecting and measuring lung nodules
how using CAD software alongside clinician interpretation affects scan review and reporting time
the prevalence of nodules in people who have a chest CT scan because of signs or symptoms that suggest lung cancer.
Why the committee made these recommendations
Using AI‑derived CAD software to assist reviewing CT scans could improve the detection of lung nodules.
In targeted lung cancer screening, the evidence is too limited to show which technologies are the most clinically and cost effective. But the model results suggest that using the software alongside clinician review has the potential to be cost effective. So, although there is not yet enough evidence to recommend the software, centres already using it as part of the targeted lung cancer screening may continue doing so if further data is collected to make sure the benefits of using the software are realised in practice.
Outside of targeted lung cancer screening, using the software could lead to more people being wrongly diagnosed with lung nodules, and having unnecessary CT surveillance. This is very uncertain because there is so little evidence, but having CT surveillance may cause people unnecessary anxiety, so more research is needed.
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